Top 177 Directors of Jobs in Jackson, Ms

Director, Health Plan Provider Relations
Molina Healthcare —Jackson, MS
- $87,569.00 - $189,732.18 a year
- Full-time
- 3 years
- Presentation skills
- Organizational skills
- Health insurance
Director
Jackson State University —Jackson, MS
- Weekends as needed
- School experience
- High school
- Experience working with individuals with disabilities
- Disability insurance
- Dental insurance
22h
Regional Director of Operations - TN, AL, AR, LA, MS
Option Care Enterprises, Inc. —Jackson, MS
- $155,561.01 - $259,268.34 a year
- Full-time
- Remote
- RN License
- 3 years
- Master's degree
- Health savings account
- Health insurance
Quick Apply
Deputy Director of Creative, Design
Southern Poverty Law Center —Jackson, MS
- $115,200 a year
- 5 years
- Office
- High school diploma or GED
Assistant Director of Residence Life
Jackson State University —Jackson, MS
- Full-time
- Residential
- Master's degree
- University
- Disability insurance
- Dental insurance
Director of Web Strategy and Digital Experience
Jackson State University —Jackson, MS
- Full-time
- Marketing
- University
- Bachelor's degree
- Disability insurance
- Dental insurance
Director-Children's Safe Center
The University of Mississippi Medical Center —Jackson, MS
- Full-time
- Clinic
- Bachelor's degree
- Driving
11d
Community Director
Jackson State University —Jackson, MS
- Full-time
- Inventory management
- Customer service
- Mid-level
- Disability insurance
- Dental insurance
Graduate/Undergraduate Programs Associate Director
Jackson State University —Jackson, MS
- Full-time
- Doctoral degree
- Master's degree
- University
- Disability insurance
- Dental insurance
Executive Director of Student Health and Wellness Clinic
Jackson State University —Jackson, MS
- Full-time
- Nursing
- Medicine
- OSHA
- Disability insurance
- Dental insurance
Director of Operations
The Solutions Team Inc —Flowood, MS
- 7 years
- Senior level
- Leadership
11d
Director & Assistant/Associate Professor
Jackson State University —Jackson, MS
- Full-time
- Doctoral degree
- University
- Education
- Disability insurance
- Dental insurance
Director of Women's Services - RN
Merit Health Central —Jackson, MS
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Quick Apply
Director of ICU
Merit Health River Oaks —Flowood, MS
- Full-time
- Nursing
- RN License
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
Corporate Assistant Fixed Ops Director - Automotive Industry
Cannon Motors of Mississippi —Mississippi
- Up to $120,000 a year
- Full-time
- Dealership
- Mid-level
- Travel
- Disability insurance
- Health insurance
Quick Apply
4d
Director of Construction Operations
Upchurch —Jackson, MS
- $175,000 - $200,000 a year
- Full-time
- Construction site
- 11+ years
- Office
- Paid holidays
- Dental insurance
Quick Apply
Lead Director, Head of Product Execution
CVS Health —Jackson, MS
- $100,000 - $231,540 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Fair chance
- Health insurance
- Dental insurance
3d
Director-Educational Operations
The University of Mississippi Medical Center —Jackson, MS
- Full-time
- 6 years
- Analysis skills
- University
8d
Associate Director of Financial Aid
Jackson State University —Jackson, MS
- Full-time
- Research
- Windows
- Analysis skills
- Disability insurance
- Dental insurance
Area Director
Sonny’s BBQ —Brandon, MS
- $80,000 - $100,000 a year
- Computer literacy
- Quick service & fast food restaurant
- Travel
- Relocation assistance
- Health insurance
Quick Apply

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directors of jobs near jackson, ms

Director, Health Plan Provider Relations

Molina Healthcare -
Jackson, MS

Apply Now

Job Details

Full-time
$87,569.00 - $189,732.18 a year

Benefits

Health insurance

Qualifications

Medicare
Managed care organization experience
Team leadership
Presentations for conferences or internal meetings
Health insurance knowledge
Productivity software
Healthcare reimbursement methods
Cross-functional collaboration
Cross-functional communication

Full Job Description

***Remote and must live in Mississippi***

JOB DESCRIPTION

Job Summary

Leads and directs team responsible for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures. Collaborates with network leadership and the corporate network team to develop and implement standardized provider relationship management and provider services for the health plan.

Essential Job Duties

Oversees the plan’s provider relations function and team members. Responsible for the daily operations of the department, including leading and supporting various provider relations activities including provider education, outreach and inquiry resolution.
Develops health plan-specific provider relations strategies - identifying specialties and geographic locations to concentrate resources for the purposes of establishing a sufficient network of participating providers to serve the health care needs of the plan's members, and successfully develop and refine cost-effective and high quality strategic provider networks - ensuring establishment of both internal and external long-term partnerships.
Collaborates with health plan network management and operations teams and functional business unit stakeholders to lead and/or support various provider services functions and strategic initiatives with an emphasis on developing and implementing standards, resources, tools and best practices sharing across the organization.
Develops and deploys strategic network planning tools to drive provider services and contracting strategy across the organization. Facilitates planning and documentation of network management standards and processes for all line of business.
Provides matrix team support including, but not limited to: new markets provider/contract support services, resolution support, and national contract management support services.
Builds and/or facilitates provider communication, training and education programs for internal staff, external providers, and other stakeholders.
Ensures compliance with applicable company/plan business requirements including state/federal statutes, government sponsored program requirements, and network access standards.
Oversees and leads provider representatives activities, including developing and/or presenting policies and procedures, training materials, and reports to meet internal/external standards.
Assists with ongoing provider network development and the education of contracted network providers regarding plan procedures and claims payment policies.
Develops and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards related to provider relations.
Oversees appropriate and timely interventions/communications when providers have issues or complaints (e.g., problems with claims and encounter data, eligibility, reimbursement, and provider website).
Serves as a resource to support the plan’s initiatives and helps to ensure regulatory requirements and strategic goals are realized.
Ensures appropriate cross-departmental communication of provider relations initiatives and contracted network provider issues.
Designs and implements programs to build and nurture positive relationships between contracted providers, ancillary providers, hospital facilities and the plan.
Develops and implements strategies to increase provider engagement in Healthcare Effectiveness Data Information Set (HEDIS) and quality initiatives.
Engages contracted network providers regarding cost control initiatives, medical cost ratio (MCR), non-emergent utilization, and Consumer Assessment of Healthcare Providers and Systems (CAHPS) to positively influence future trends.
Develops and implements strategies to reduce member access grievances with contracted providers.
Oversees the integrated health home (IHH) program and ensures IHH program alignment with department requirements, provider education and oversight.
Hires, trains, manages and evaluates team member performance - provides coaching, development, and recognition; ensures ongoing appropriate staff training, holds regular team meetings, and drives communication and collaboration.

Required Qualifications

At least 8 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products, or equivalent combination of relevant education and experience.
At least 3 years of management/leadership experience.
Strong understanding of the health care delivery system, including government-sponsored health plans.
Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
Previous experience with community agencies and providers.
Strong organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Experience with preparing and presenting formal presentations.
Strong interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Excellent verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Contract negotiation experience.

#PJHPO

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $87,569 - $189,732.18 / ANNUAL

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

directors of jobs in jackson, ms

Director, Health Plan Provider Relations

Director

Regional Director of Operations - TN, AL, AR, LA, MS

Deputy Director of Creative, Design

Assistant Director of Residence Life

Director of Web Strategy and Digital Experience

Director-Children's Safe Center

Community Director

Graduate/Undergraduate Programs Associate Director

Executive Director of Student Health and Wellness Clinic

Director of Operations

Director & Assistant/Associate Professor

Director of Women's Services - RN

Director of ICU

Corporate Assistant Fixed Ops Director - Automotive Industry

Director of Construction Operations

Lead Director, Head of Product Execution

Director-Educational Operations

Associate Director of Financial Aid

Area Director

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